Patching for corneal abrasion

Turner, Angus; Rabiu, Mansur

doi:10.1002/14651858.cd004764.pub2

Cited by 37 publications

(21 citation statements)

References 32 publications

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“…Moisture chambers and eye patching or taping are particularly effective when used at night. Some authors have not recommended or have discouraged eye patching 89,94,95 due to the risk of corneal damage from poor patient execution of the procedure. Despite these concerns, many authors have reported successful use of both interventions.…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Bell's Palsy

Baugh

Basura

Ishii

et al. 2013

Otolaryngol.--head neck surg.

379

114

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Objective Bell’s palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mono-neuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with facial nerve weakness/paralysis. Bell’s palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell’s palsy may cause significant temporary oral incompetence and an inability to close the eyelid, leading to potential eye injury. Additional long-term poor outcomes do occur and can be devastating to the patient. Treatments are generally designed to improve facial function and facilitate recovery. There are myriad treatment options for Bell’s palsy, and some controversy exists regarding the effectiveness of several of these options, and there are consequent variations in care. In addition, numerous diagnostic tests available are used in the evaluation of patients with Bell’s palsy. Many of these tests are of questionable benefit in Bell’s palsy. Furthermore, while patients with Bell’s palsy enter the health care system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell’s palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell’s palsy. Purpose The primary purpose of this guideline is to improve the accuracy of diagnosis for Bell’s palsy, to improve the quality of care and outcomes for patients with Bell’s palsy, and to decrease harmful variations in the evaluation and management of Bell’s palsy. This guideline addresses these needs by encouraging accurate and efficient diagnosis and treatment and, when applicable, facilitating patient follow-up to address the management of long-term sequelae or evaluation of new or worsening symptoms not indicative of Bell’s palsy. The guideline is intended for all clinicians in any setting who are likely to diagnose and manage patients with Bell’s palsy. The target population is inclusive of both adults and children presenting with Bell’s palsy. Action Statements The development group made a strong recommendation that (a) clinicians should assess the patient using history and physical examination to exclude identifiable causes of facial paresis or paralysis in patients presenting with acute-onset unilateral facial paresis or paralysis, (b) clinicians should prescribe oral steroids within 72 hours of symptom onset for Bell’s palsy patients 16 years and older, (c) clinicians should not prescribe oral antiviral therapy alone for patients with new-onset Bell’s palsy, and (d) clinicians should implement eye protection for Bell’s palsy patients with impaired eye closure. The panel made recommendations that (a) clinicians should not obtain routine laboratory testing in patients with new-onset Bell’s palsy, (b) clinicians should not routinely perform diagnostic imaging for patients with new-onset Bell’s palsy, (c) clinicians should not perform electrodiagnostic testing in Bell’s palsy patients with incomplete facial paralysis, and (d) clinicians should reassess or refer to a facial nerve specialist those Bell’s palsy patients with (1) new or worsening neurologic findings at any point, (2) ocular symptoms developing at any point, or (3) incomplete facial recovery 3 months after initial symptom onset. The development group provided the following options: (a) clinicians may offer oral antiviral therapy in addition to oral steroids within 72 hours of symptom onset for patients with Bell’s palsy, and (b) clinicians may offer electrodiagnostic testing to Bell’s palsy patients with complete facial paralysis. The development group offered the following no recommendations: (a) no recommendation can be made regarding surgical decompression for patients with Bell’s palsy, (b) no recommendation can be made regarding the effect of acupuncture in patients with Bell’s palsy, and (c) no recommendation can be made regarding the effect of physical therapy in patients with Bell’s palsy.

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Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Bell's Palsy

Baugh

Basura

Ishii

et al. 2013

Otolaryngol.--head neck surg.

379

114

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“…When they excluded two quasi-randomized studies, the results concurred with our findings. The average abrasion area in our study was 3.8 ± 3.5 mm 2 with a high homogeneity in all three groups as opposed to average areas ranging from 1.6 to 23.7 mm 2 in the studies used for comparison in the aforementioned review [4]. Since our trial was not designed to study very large abrasions or recurrent erosions, the results and recommendations reported here cannot be thoroughly applied for such cases.…”

Section: Discussionmentioning

confidence: 75%

“…The recently published meta-analysis from Turner and Rabiu [4] found a significantly faster healing time in the groups without patch (compared to with patch) in the treatment of simple corneal abrasions. When they excluded two quasi-randomized studies, the results concurred with our findings.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of an ophthalmic ointment in preference to antibiotic eye drops include a longer contact time of the applied substance on the ocular surface and increased lubrication, which shields the epithelial defect from constant friction by the eyelids. An extensive Cochrane systematic review by Turner and Rabiu [4] was conducted to determine the effects of eye patching for treating corneal abrasions. In their review of studies[5,6,7,8,9,10,11,12,13,14,15], they found no evidence for the use of eye patches for simple corneal abrasions as they did not improve day 1 postinjury healing rates nor reduce pain, and were associated with discomfort [4].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Traumatic Corneal Abrasions: A Three-Arm, Prospective, Randomized Study

et al. 2013

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Purpose: To compare three different treatment modalities for traumatic corneal abrasions. Methods: We conducted a prospective, randomized, masked, three-arm clinical study of patients presenting with superficial corneal foreign bodies. Treatment modalities were: (1) pressure patching with ofloxacin ointment (patch group, PG, n = 18), (2) therapeutic contact lens with ofloxacin eye drops (contact lens group, CLG, n = 20) and (3) ofloxacin ointment alone (ointment group, OG, n = 28). Primary outcome measure was the difference of the mean corneal abrasion area between the three groups at 3 different time points (baseline, day 1 and day 7). Results: A total of 66 patients were included in the study over a period of 2 years. Mean initial corneal abrasion area was 3.6 ± 3.4 mm² in the PG, 4.2 ± 4.0 mm² in the CLG and 3.7 ± 3.1 mm² in the OG (p = 0.875). Differences in corneal abrasion area at any time point were not statistically significant (abrasion area decrease from presentation to day 1 was 3.4 ± 3.3 mm² in the PG, 4.1 ± 4.0 mm² in the CLG and 3.5 ± 3.1 mm² in the OG, p = 0.789). The epithelium was healed in all patients at day 7. Conclusions: Treating traumatic corneal abrasions by pressure patching, a bandage contact lens or ointment alone was equal in reducing the abrasion area or reducing pain. According to our results the treatment of choice for traumatic abrasions may be adapted to the needs and preferences of the patient.

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“…A Cochrane Review concluded that treating simple corneal abrasions with a patch does not improve healing rates and does not reduce pain [13]. This was true for traumatic corneal abrasions and CFBs [14].…”

Section: Further Managementmentioning

confidence: 99%

Get Out of a Scrape! An Approach to Corneal Foreign Bodies and Abrasions for the Primary Care Physician

Squissato¹,

Brown

Baxter³

2015

Occup Med Health Aff

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Work-related injuries (WREIs) to the eye are common. Many are minor but, if not treated quickly, can lead to vision-threatening complications. Others are severe, but even with expert management sight can be lost. This article promotes an understanding of the physician's role in the prevention, assessment, and treatment of WREIs. By far the most common WREIs are corneal foreign bodies (CFBs) and abrasions, which this article primarily focuses on. Foreign bodies (FBs) visualized under slit lamp microscopy can be removed with a moistened cotton tip or bent 25-gauge needle followed by antibiotic and tetanus prophylaxis. Pain associated with corneal abrasions can interfere with daily functions including return to work. Adequate pain relief may be achieved using oral nonsteroidal antiinflammatories. Patching is not recommended because it does not improve comfort and may impair healing. Noncomplicated CFBs need only to be seen once by an ophthalmologist 4-6 days after the initial presentation.

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Patching for corneal abrasion

Cited by 37 publications

References 32 publications

Clinical Practice Guideline: Bell's Palsy

Clinical Practice Guideline: Bell's Palsy

Treatment of Traumatic Corneal Abrasions: A Three-Arm, Prospective, Randomized Study

Get Out of a Scrape! An Approach to Corneal Foreign Bodies and Abrasions for the Primary Care Physician

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